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everen <br />� <br />CITY ENGI IFERS <br />EVERETT. 'RASHINGTON <br />APPt.it;ATICN FQR RIGHT•OF-WAY USE PFRMIT <br />The Undersigned �� ' � � ��� � � �' <br />Hereby applies for permission to <br />10396 ��✓� <br />/ <br />,�i7�iG.. <br />PERMIT N0. /( > � ��� <br />.!^,'i�',,/.�-n .. ,-' �,-y' -' � ,. �i./%_ , i%J %'7r� :�'-"YC.M�� � <br />A[ the fo�lowing location `���-�-'.° ` _��� "�� �� "�� (�'� — <br />(Work to be done) <br />�/ �L. <br />� <br />—�_ ' <br />�/�,,�J�,_ t -`� ��! <br />�T' �[.7f�/�L% Q'��..FiL1L��✓/ <br />_ " `� � !�✓�,�r> <br />__�� � <br />_ _ -;- —= �y rr — <br />:y )i✓S , <br />DRIVEWAY SECTION <br />NO SCALE <br />�•�---- �� � -- —� <br />jl" LIP <br />30 �__.. ____�30 J <br />'i <br />COPY OF THIS APPLICATION TO <br />6E POSTED ON JOQSITC. <br />C�LL FIJGi;JF_ERIhdG DEPT. 259�8811 <br />?4 !Is�URS ;;[FOiiC CONSTRUCTIOhJ <br />CHECK LIST <br />Water Valve <br />Dreinage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Custoine�. <br />1 i'opY to File �'�� 1 n 3 q 6 <br />1 CoFY to Inspecror l� <br />i <br />�j <br />4.` <br />r <br />S/'� "��i <br />The undersigned ownrr hereby agrees to hold and <br />J� save harmless the City of Everett from any and aIl <br />l:' �� /, _�' � claims for damages that may arise ber.ause of installa� <br />4� � tion and mainrenance of the improvement herero <br />'�� �� app!ied for and further agrees to remove same upon <br />1 "I. <br />�j� 1� � notice from ihe Ciry and to replace public property <br />r <br />damaged thereby. �:" S �N"?� <br />�� �l. ��p ' � � . <br />, /t � s..r ; '9c C.'�-7 ���....-� <br />� /��' Signature o Applicant „ <br />i <br />0 <br />//� �'3's �,c� ' <br />� A�id�- <br />d2 Sy -�s ' - <br />Telephone Number <br />:.i .:� ; ; '� <br />Date <br />ri;� = ;� - :,,,;.- 'c � � <br />J , <br />Fee <br />Approved b v � /� <br />3 �� � .-�� - <br />ate proved <br />� <br />